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HomeMy WebLinkAbout2222DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.05 -1 -14 BOX 19 oil 1�.L .. Ll yl, , 02222 3 7 PUTNAM COUNTY DEPARTMENT OF',HEALTH 'ENGINEER MJUST N. Y. 1051 1 2 PROVID'E Division of. Environments/ Health Services, Carmol, 1kc Put�lum. �111 .1 y CERTI ATE OF' CONSTRUCTION COMPLIANCE FOR* SEWAGE DISPOSAL., SYSTEM \J Town or Village .�08 I Arldgli Road `9' Located at Tax Hap­,�.. Block OwnerMichael 'Dolan qnrly Tax gap Lot # - 9 Subd. Lot Howard Gftgert'- oscaweAa Ta e, Road Separate Sewerage System built by' Address Consisting of 1000 1 Gal. Septic Tank and . 120 LF of Tri Galleries Other requirements-,: Ft + of -ROB .Gravel in -Place blin of 90 -days Water Supply: Public Sul ply' From vote "I' Albert Hyatt_ & Son X Prl� Sup p y Drilled _By Building Type No..of Bedrooms Date Permit Issued Has Erosion Control Been Completed? Ye s Has garbage grinder been installed? No 000 )UP G 000a, -EN I certify that the system(s) as listed serving the above premises were constructed essentially as 812;.9 ,4Aq,completed work copies 1 0: in of which are attached), and In accor,�1ince'-w­11th the standards, rulea'and regulati*ns, accordanc% f%le 9' d-tM permit issued by the Putnam County Department Of Health. 0 0 4L 11 0 June 1986, 5. X Date Certified by = OP.E. R.A. Address - Northrkke o(A Peekskiij,N� AW .nse 0; 27846 ,o. 0 2 84ro -0 Any person occupying, premises servidby-thle above system(s) sha'll'.P'rorhlitly take.such action as may be %* a corilction of any unsanitary conditions resulting from such usalie. , 'Approval of the separate we , rage ., system shall become null and I); olk sanitary sower becomes M available and the approval of the private water supply shall bec . ome n ll and Vold when , a public water supl)W DeCOANf pitiable. Such approvals are subject to modification or change when in the judgment of the fmisover H such revocation, MoUlfleati8n or change is necessary. Date By A Title Rev.. 6/85 ? [+C QUELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH 3/71 Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is.to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME P SC f Llr,>} v ,J 1� M4,5 IY I . Cl ` c 11",� ADDRESS /� - . �J ? 3 % B V P W � /L LOCATION OF WELL . (No. 8 Meet) (Town) (lot Number) �44-' Utn-It- OIL I"fjL ' + i't PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ SUPPLY ❑ INDUSTRIAL AIR 1—I OTHER CONDITIONING �J (Specify) DRILLIPIG EQUIPMENT rVCOMPRESSED CABLE OTHER ❑ ROTARY AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet) DIAMETER (Inches) "7 WEIGHT PER FOOT U THREADED ❑ WELDED S O YES ❑ NO YES NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED OMPRESSED AIR YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE -STATIC (Specitj feet) DURING YIELD TEST 1 feet �' %-� Depth of Completed Well / in feet below Land surface: ��`-✓ SCREEN MAKE LENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION. Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WEII COMP ETED DAT REPORT WELL DRILLER (Signature) Yorktown Medical Laboratory, Inc. 321 Kear Street Yorktown Heights, N. Y. 10598 (914) 245 -3203 Director: Albert H. Padovani M. T. (ASQ) 71 '13 `7 L r0 N,2 t; 1 " r l C� %� G% J 0 (16 7 LAB it n 2� 238U1'j Collection Station Used: Carmel.— Peekskill _ Mt. Kisco _ New City _ Date Taken: Date Received: Date Reported• • — Collected B y: .,epe Referred By: Sample Source: 7;4W..' t) A ,% /lJ 5 De doulrkh" /0,c A.41 Ail; ARit-eve LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA Standard Plate Count per 100 ml (Agar plate C 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform per 100 ml Fecal Coliform per 100 ml _ Fecal Streptococcus per 100 ml MOST PROBABLE NUMBER TECHNIQUE (MPN) Total Coliform: Fecal Coliform: OTHER ANALYSES MPN Index•ner 100 ml MPN Index-per 100 ml • THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING T THE NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert H. Padovani, M.T. (ASCP), Director LEGEND RDS = Recommend Disinfect- ing Water Source < = less than TNTC = Too Numerous Too Count PUT'NAM COUN`T'Y DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Michael Dolan 9 9 Owner or Purchaser of Building Section Block Lot Michael Dolan Building Constructed by Oakridge Road Roaring Brook Location - Street Subdivision Name Putnam Valley 498 Municipality Subdivision Lot # Modular Building Type GUARANTEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage disposal system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environinental Health Services of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system° lib may 86 Dated —t,�is day of 19. Signature Title Contractor - (Owner) - Signature Corporation Name (if Corp,) rT:r. - rev. 9/85 mk Corporation Name (if Corp.) Address •1! Yorktown Medical Laboratory, Inc. 321 Kear Street Yorktown Heights, IN. Y..10598 (914) 245 -3203 M i LAB # Collection Station Used: Carmel _ Peekskill _ Mt. Kisco New City _ Director: Albert H. Padovani M. T. (ASCP) T- 1 Date Taken : J —,IV—S7 r-- — S D6 Date Received: a� Date Reported:. kk C o 11 e c t e d B y: /'Im.", O.i.C�7' ✓� Referred By: L XG,N.& t,`3t S lG �0/ J Sample Source: 7A//M°_ , Ofd- ✓° /��� V/)_1f cy LABORATORY REPORT ON BACTERIOLOGICAL QUALITY OF WATER GENERAL BACTERIA V Standard Plate Count per 100 ml l (Agar ,plate C 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform 100 ml per Fecal Coliform per 100 ml _ Fecal Streptococcus per 100 ml MOST PROBABLE NUMBER TECHNIQUE (MPN) Total Coliform: MPN Index *Der 100 ml — Fecal Coliform: MPN_Index per 100 ml OTHER ANALYSES I THESE RESULTS INDICATE THAT THE WATER SAMPLE (WAS) ,WAS NOT) (NOT APPLICABLE) OF'A SATISFACTORY SANITARY QUALITY ACCORDING NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. Albert H.^Padovani, M.T. (ASCP), Director LEGEND. RDS = Recommend Disinfect- ing Water Source < = less than TNTC = Too Numerous Too Count i ~ IPUTNAM C ®BJNM DEPARTMENT ..,O1F. 1H[EA LTH[ Diyision;of Environmental Health :$ewices, :Carmel, N. Y. 10512..,, COftIS RUCT90iU PEFiMBi. 06i.SEUUAGE DISPOSAL SVSiEfUi PAtriarn -: "Valley (T) Located at 0akr.ldge `Drri Tax map ' 9. orB ofck9 1 Town subdivislon Roaring" Brook Lake :fifth Map` Lot 498 (9) -Job Owner Michael. Dolan Address _f Warburton Avenue Modular 2,;339 SF: Yonkers, NY 10701 Building Type Lot Area g ay Number, of "Bedrooms :Desl n ..Flow Total ,Habitable :Space Square Feet 9 1000 120LF 04 Tri= g alleries. Separate - Sewerage- System to consist of Gal Septic Tank and Jet Nika Lake Peekski ,NY To. be .constructed by—, y ddre.ss ' A Water Supply: Public Supply, From x 'Bea]. Well. Drillers Private Supply_.to be drilled _by revs . er, . _ , Address' Other Requi ►enierit3 3 ft mlri of ROB. Grave. `ln place' in septic -area:: I represent that: im wholly and completely responsible for the design and •location of ;the ,proposed system(s),' 1) that .the separate sewage disposal system above_descnbed .will be constructed as.shown on`the approved amendriient th "ere to 'and' ' accordance with the st�iWW , I _ an regu a, ions o e Putnam County .Departme,nt of Health, and that :on completion thereof a 'Certificate of Construction Corriplian�e5 f the Commissioner'of Healthwill: be subm tted.`to' the Department,, and a written; guarantee'',will be. furnished the owner h,s'successors t�g•'builcl r tFiat said builder will place 'in, good operating condition any part of�,said sewage disposal system during the.per.iod of .t�qo )�g i y 4gllow:ing the.date of,the'isSu- ance' of. the approval of the Certificate 'of Construction Compliance ,of the original system or an 4 r t t drilled well 'described above . will 'be located as sfimvnon the approved plan and tha_ t said, well will be installed in "accordance with dh� t ar s itla i� on'of:­ ' of : the. Putnam . .County Department of Health. June 3, 198:5 o ' a e Signed Dat P.E R A Address _ l : Northrid a oad Peekski <3 ,censdNo. 2��p APPROVED FOR .CONSTRUCTION: This approval expires one year from the date. issued unless cd%tr o df� eTY6 ildin 4ias been undertaken and is' revocable for cause or maybe amende . or modified when co red necessary by the C i ner o94 i� MratFion .of construction regwres. a new permit. Appr for disposal of domestic sari to y sewage; and /or: rivate ter' supplyr�i.11C s BY i Title 1 PUTNAM COUNTY 'DEPARTMENT OF HEALTH Division,: of Environmental Health Services Carmel, . N. Y;` 10512 , CONSTRUCTION PERMIT' FOR SEWAGE, DISPOSAL SYSTEM.'_ f— yeti' ®F %°�,r,•rq,=�j l�a4G,,S� O/Q!�— Tax`Map �... or, Block Located at 9e s' I :Town Subdivision Lot Job Owne► ✓O .: S Joie.. Address l� ©`. 6,0;k3 6...L!►/��5/7�,P� _ /.vg Building Type �SI�E.r Pi L Lot Area SS r9'���s! %�rPll/� / yin/ANl !/.4Lzc' -K 7 Number -of Bedrooms ' Desigrl'FIow4 ��? ��a Total Habitable Space Q�E� ; Square .Feet e� + �DO: ` LAN= Separate Sewerage System, to c nsist of Gal Septic Tank and`j7,' A/ To be - constructed by 4 p_L �/�L�1{ Address �� Water Supply: Public SuPPIy From ;I + Private Supply to be ^drilled by JO, 4j Address . i : ,I• ' , , .} Other Requirements 1 ✓+�+/� EL ` LG • ©_.1 LL . • o YNS:ALea.r,•�d e,4 Y� S I represent that I 'am wholly and completely responsible `ation of .the proposed system(s); 1), that the separate sewage disposal system above described will be :constructed as shown on the a h to and,l�n accordance with the standards, rules an regu a ions o e u nam De artment of and t . , +• p _ r pliance'satisfactory to the .Commissioner of Health will be submitted to the Department; antl a: written I owner his successors heirs or assigns by the'builder, that ,said builder will Count p hat on tom f � f Construction Compliance',! place in ,good operating condition any 'part sy in g the. period of two (2) years,iMmediately.following thedate of the Issu- ance-of the approval of the ^Certificate : of Co f nth nal stem or any repairs thereto; 2) that the drilied well described above will be located as shown on'the approved plan an said 11 cc r ante with the standards, 'r les and regulations of the Putnam County Department of Health. p T Date P.E. R.A. Address)i License Nx oL� / Z 0 APPROVED R CONSTRUCTION' Thisapprovai r_ date .issued .unless construction, of the building has been undertaken and is revocable Yo 'use or may be,amended "or modified whe a r.y by the issioner.`of Health, Any change or alteration of constructlon requires, a', per Apprpved n disposal'of dornesti se age; and /or private water su nly- -- Date �(S/ By Title � _ 1 Gentlemen: ly PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date May 319 1985 Re: Property of Michael Dolan Located at Oakridge Drive Roaring Bruok Section Block i Lot This letter is to authorize ?.,John S. Romeo a duly licensed professional engineer. X Lor registered architect (Indicate) to apply for a Construction Permit for a separate sewage system; to serve the above noted property in.accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and. to sign all necessary papers on my behalf in Cu111jt.0 L.1.U11 wt Lfl L11-Lb nia c Lev anti to. supervise ine curistvuc ciur! of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, ,1 Signed I 1 ee e� 1 lu Owner' of Property �Q Countersigned: �`? �,XX�XX Address, P °E ., MHX # 27846 1 Northridge Road �`� T lephone Addresfeekskill, NY 10566 � ° ���I ENS�y ®,®®° S R f�9� ° °. 737 - 1056 c, e' Telephone a'o ® 2790 0 00 9ffQf NEYi���° ��0009® SEWAGE —i FIELD INSPECTION REPORT INITIAL SITE INSPECTION IYFS 1 NO Property lines or corners found ................ Can estimate house location ....................... Willdriveway need cut ............................ Must trees be removed - note these ................. Deep hole representative of entire SDS area....... Additional deep holes needed ....................: Sufficient SDS area available considering driveway cut, house location, separation distances,etc.;. Adjacent wells /septics...... ... . .......... .... D. H. 1 Lot Depth to G.W. Depth to rock Descri 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. D. H. 2 Lot Depth to G.W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. boll r— DATE: _ INSP. BY: COMMENTS D. H. - Deep Hole G.W.- Groundwater D.H. 3 Lot Depth to G.W. Depth to rock 0 ft. 3 ft. 6 ft. 9 ft. 12 ft. 5oll uescr DATE: FINAL SITE INSPECTION INSP.BY: YES NO COMMENTS House SSDS located per approved - plan ............ Length of trench measured Width of trench average . Slope of tile line and trench acceptable. ......: Roan allowed for expansion,trenches...... .. • Over 100 ft.. fran swamp, watercourse...... ;.. a Natural soil not stripped or SDS area unnecessarly'graded ........... . ........ ....' 10 ft. maintained fran property line and 20 ft. fran house .............................. Distance well to SSDS (ft..)... ............... o ... Number of bedroans checks...... .................. Stones, brush, stumps, rubble, etc., greater than 15 ft. fran nearest trench ................ 15 ft. of peripheral soil horizontally fran trench........ .......................... Boxes properly set .......................... ..... Could surface runoff fran driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL GRADNG OF SITE'ACCEPTABLE.. ... rev /9/85 mk J. S. ROMEO, PE, LS JOHN S. ROMEO, P.C. CONSULTING ENGINEERS & LAND SURVEYORS 1 NORT HRIDGE ROAD PEEKSKILL. NEW YORK 10566 914 - 737 -1056 June 3, 1985 Mr..Robert Tutoni, Public Health Engineer, Putnam County Dept. of Health Division of Environmental Health Services County Office Building Carmel, N.Y.10512. REs Raised permit.f or Michael Dolan Roaring Brook Lake Dear Sir: I am enclosing plans and forms for a revised permit for Mr. Michael Dolan. .The original permit for this lot was issued in 1973 It indicated 3 ft wide trenches, with 177 feet of trench. The permit has been renewed over the years and was last renewed.in June of 19.84. Mr. Dolan has contacted me and asked that I submit a new permit utilizing tri- galleries instead of the trenches, to cut down on the area covered by the fields. I have redesigned the system, utilizing 3 feet of ROB Gravel fill instead of 2 feet, and using 120 LF of tri galleries instead of 177 LF of trench. I believe the system as designed complies with the code better than the old 3 feet trenches indicated, and will satisfactorily service the property in question. I therefore request a renewal with the new design. JSRs clr Very truly yours, Jo Fn S. Romeo o. o 000 0 006 P.E. & L o S. � ptY�1 ENC /,yF�9 0 4 e o°� 0 1� a •t�'.J o 0 d 27g$6 be AF ® Kit o !S NG �E '�Pi ;.ts;� n.?o.:�iGtdv,`lu -r4" FktaNc +� =s to GAl�vt.<.L. c�V�.. PUTNAM COUNTY DEPARTMENT .OF. HEALTH lov-1 9- 'ri Diliision' of Environmental. Heakh ,Sewices; Carmel, N Y. 10512 CONSTRUCTION PERMIT FOR ;SEWAGE DISPOSAL SYSTEM_ !� a S i i Town or Vi lage QA Locatetl at � �1Q 7t Tax Map Block' Subd vision /%r l/ / 'A/ a OA nJ �10a7IL L�� �C 1 Lot Job Owner ,Q Address �rQ `f ter• �us��lY. /mss' Building Type K �.s /.ot�Nii%�4` .' Lot Area 6 - Y y , �l:>� _:5724, a 2 Number of. Bedrooms Design Flow. 7e ( t) Total Habitable'Space ny � Square Feet Separate Sewerage System to• consfist of Gal. Septic Tank and LL ia'/ To be constructed by aiv.-LI Address Water Supply. Public Supply: From �G Private SuPPIY'to be drilled by Address ZIT l L — Other :RequirementsQ� IL 'I I represent that I am wholly and completely responsi or. E' ion of 'the, proposed. system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the and ,In accordance with the standards, rules and regulations o e Putnam County Department of Health, and that on co Construction Compliance^ satisfactory to the Commissioner of Healthwill be submitted to the Department, 'and' a' writte urns owner, his successors, heirs or'assigns by the builder,' that said builder will place in good operating condition any-!pirt of sew I ste ng'the,_period of two,(2).years immediately' following the date of the issu-' ance of the approval of the Certificate: of Co tru ion m i nil syste or any repairs thereto) 2) that the drilled well described above will be located as shown on the approved plan an fy� sald Ile , -in c2ordance with 'the stan ds, 'rules and regulations ,,of. the Putnam County Department of Health. I T ned P.E. I Date z -�. I Si C�� , g R.A. J� I J,y 7 Cifl` 7 4 ?.-il Address ' License No APPROVED FOR CONSTRUCTION This approval exp the date .iss construction of the building has been undertaken and Is revocable for cause or'may be,amended'or modified 'when consi _ neces_sar! by t Commissi er, of.Health.,. Any' change or alteration of construction requires a new permit. Approved tor. disposal of domesti a ; se ge, ntl/ y 'only. Date ,� By Title c, PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of 01 i T. p / Located at'i °plc. Lot Gentlemen: /��-' Loi This letter is to authorize -` STANLFJ I L'A�L a duly licensed professional engineer ✓ or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and. to sign all necessary papers on my behalf in a:wliiC�t L11111 w.L Ln Litls ma L Lev alui to. supervise the construc ciun of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public. Health Law, and the Putnam County Sani- tary Code. rind° ounte s g e P .E ., ., # -327 Very truly yours, Signed 1A `11 Owner /6f Property Address Telephone Telephone c ♦ Y ' 1 r 'b' .i APR 2 8 1983 PUTNAM COUNTY DEPT, W hIALTH F 77 ip 11 r - '�•, '� 3i�i - ' PUTNAM COUNTY DEPARTMENT :OF HEALTH ; J _ Division of Environmental Health Services Carmel N Y 10512 °CONSTRUCTION PERMLT FO SEWAGE'DISPOSAL SYSTEM' Still �%F w. �✓ii / ✓J i�"L� r .i/ illoge v Town or Located `at i, l SA N 12 Block l Subdivision ��'/ �c6J QO�' Lot ' Job Owner PAT/{ C� Address/ �C�la6 C7z►ji /�/� a E n .1- yq. ><� 'ti /i3 L Lot Area Building Type E3 i f a , -- T� i Number'. f Bedrooms ' :.] Total Habitable Space Square.Feet' 1 ra.isEP% .f —`° v ; Separate- Sewerage System to consist of Gal Septic Tank lineal feet. X ' width trench To be constructed by; 10AiS Address . i water SUPPIY . , Public SUPPIY, From + Private :SUPPIY to be .drilled by Atldress' a v°- 1 Other Re4uirements r I represent that I' am wholly and;,completely responsi r e n n . of the proposed systpm(s) 1) that the separate sewage :disposal system above described;:will•be �constructed'as shown on •the entlin _ ,. nd in accordance•with the standards; rules an regulations o e Putnam ,County _.Department of.- Health, and that on.coip Construction Compliance satisfactory to the Comrnissioner;of Healthwill - be, submitted to .the .Department; and a - writ'te a ill u 's caner his' succe ;sors hens or assigns 6y the builder, that'said builder will place : in good operating -condition any,, part- of wa em g the period of two (2) Years. immediately following the date of the. issu- *•`, t ance ;of° the approvalof;ahe ,Certificate of Co ruc on [�I the ri al ysteiri or any repairs thereto; 2)'that the drilled well described above w�ll.be, located as `shown on the approved, plan and id: [. $�1ity fled ordance with the staiidar rules and regula i—%ns of the' Putnam County Department of Health , 4. .e ?' v Date •:P E' a_ R.A. Address ++ �� License No, -� _�. APPROVED: FOR CONSTRUCTION: 'This approval expires the'date„ ssued ,unless' construction of the building has been undertaken and is revocable .for .cause 0r May:be' amended or modified whe'considered necessary by .t a Commissioner' of Health. Any, change or alteration .of, construction Dateres.a �ewApproved for disposal of domestic cant_ y sewage ad /or prifsupply 'only 'By a Title : i • . PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date , bc' Re . Property of Located at Olq'< 'r . 6e- //'� )) , i / �ra%n� r !� �'F��z� �C.JK i r T J I Block % Lots Gentlemen: This letter is to authorize U a° a duly licensed professional engineer � or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system; to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Department of Health, and to sign all necegsary papers on my behalf in connection with this matter and to.supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. Very truly yours, Signe Ow of operty 'ounter Ad- P.E., Ad re s s . �, # `���� ® elephone Addr o X 267.• f >� AMAWALM N.- Y N 245-2645 Telephone PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMEPiTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA-SEEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. �.� _ Owner�lH�c:s til, AC 4r,<i sl,4(_ Address �/ex""o C"C Located at (Street D/)1,;:k/a e , Block Indicate neares cross s ree _ Municipality,. i }' j�r7-��ir� (��i�i_��/ Watershed �0,alzj,&i6 SOIL PERCOLATION:TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Rol-e" Number CLOCK TIIC- PERCOLATION PERCOLATION. Run apse Depth to Water a er Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches 'Inches Inches 2 2i 4 2 3 4 Notes: 1) Tests to be repeated at same depth until aroximately equal soil rates are obtained at each percolation test.hole. A11 pp data to be sub►nitte'd for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA RLQUIRED TO BE STJBMITTED WITH APPLICATION DESCRIPTION OF SOILS E11CCUVT RED IN TEST HOLES DEPTH HOLE NO I HOLE NO. P7i G.L. � �►� _.. c'�T, a 1G 12" Sfax .1 _ i ii 24" rl y 3O rl HOLE N0. y y THIS SPACE FOR USE BY HEALTH DEPARTP2ENq Soil Rate Approved Sq. Ft /Cal. l y mate h 4,11 1 36,. 42" d � 48" � 5411 ° 60" 66" .-.2„ , 84.1 u _ . y �% INDICATE LEVEL AT WHICH GROUND WATER IS E14COUNTERED INDICATE LEVEL TO WHICH WATER L1= +�,rEL RISES AFTER BEING ENCOTJNTEREDri r 'TESTS MADE BY ' %,rt/uf!% Date - 7 %� Soil Rate Used Min/l "Drop: DESIGN S.D. Usable Area Provided No. of Bedrooms . Septic Tank Capacity .19oo Gals., Type Absorption Area. ::Provided By :'7 L.F. x24" o ✓` - ,width trench. Other U ST �� Address RUMAI K_ N. Yo 10501 � , "- s�'jr�'(j• THIS SPACE FOR USE BY HEALTH DEPARTP2ENq Soil Rate Approved Sq. Ft /Cal. l y mate h FIELD CIJE CK 1 IST INITIAL SITE INSPECTION Property lines or corners found , Can estimate house location . . . . . Will driveway need cut ... Must trees be removed =note these . . Is deep hole representative of entire SDS area Additional deep holes needed. . . !. . . Sufficient SDS area available considering ,driveway cut,house location,separation , . . distances ' etc., . . . . . . . . I . DEEP HOLE DATA Depth: Water elevation. Rock elevation: Soils description: Date: FINAT, SITE INSPECTION. Insp. by: House located where shown on approved plan . . SDS 'located where approved . . ..., ... .. Width of trench average u Slope of the line and trench acceptable , Room allowed for expansion trenches , , Over 50 ft. from,swamp,watercourse . Natural soil not stripped or SDS area unnecessarily graded 10 Ft. maintained from prop.line and 20 ft. from house . e ;. Separation of trench from house, well etc. follows plan . . . . . . . Number of bedrooms checks . . Stones, brush, stumps, rubble, etc. greater than 15 ft. from nearest trench . . .1. . . 15 Ft. of peripheral soil horizontally from trench Junction boxes properly set Could surface run off from driveway, roads, ground surface, etc. channel near SDS;. . e area. . . . . . . . . . . . Does'lot drainage 'appear O.K. in area of SDS FINAL GRADING OF SITE ACCEPTABLE i D a t - �.. Insp by: 91 Yes No W Comments 9 Lor SOO 'go 11 90' Z -r 498 L= 37.82' 2= Bso' Lo/ N -°. q9B as .Tha-w on Mgort/° .30BS �nf���/ed 'i�iFT/+' /s'✓�P, o j ,Qc.�9,e ins ,8�oo.0 LA•�' ' yT,' /ee ,n �`%ie Gje �f ffie Counf�c C /e�k aarMel N-Y. CERTIFIED TO: SURVEYED: BROUGHT TO DATE BROUGHT TO DATE JOHN SALVATORE ROMEO Consulting Engineer � Land Surveyor 1 NORTHRIDGE ROAD PEEKSKILL. N. Y. N 0 o. I � N V s -71, SURVEY OF PROPERTY FOR RA �JC I S (J�"\ 1. L L ELLEN , " All certifications hereon are valid for this map and copies thereof only if said map or C CA Yl. V copies bear the impressed seal of the sur- SITUATE IN THE veyor whose signature appears hereon. TDW IJ OF pUT1JAM VALLEY "it is hereby certified that this survey was 'PUT NAND COUNTY prepared in accordance with the existing NEW YORK I a a of L= 37.82' 2= Bso' Lo/ N -°. q9B as .Tha-w on Mgort/° .30BS �nf���/ed 'i�iFT/+' /s'✓�P, o j ,Qc.�9,e ins ,8�oo.0 LA•�' ' yT,' /ee ,n �`%ie Gje �f ffie Counf�c C /e�k aarMel N-Y. CERTIFIED TO: SURVEYED: BROUGHT TO DATE BROUGHT TO DATE JOHN SALVATORE ROMEO Consulting Engineer � Land Surveyor 1 NORTHRIDGE ROAD PEEKSKILL. N. Y. N 0 o. I � N V s -71, SURVEY OF PROPERTY FOR RA �JC I S (J�"\ 1. L L ELLEN , " All certifications hereon are valid for this map and copies thereof only if said map or C CA Yl. V copies bear the impressed seal of the sur- SITUATE IN THE veyor whose signature appears hereon. TDW IJ OF pUT1JAM VALLEY "it is hereby certified that this survey was 'PUT NAND COUNTY prepared in accordance with the existing NEW YORK I Fr (,aA4bc 0— '41 (off IS A\ AVI C.5 10 _2\ NO T JE•s 4 11 3 Fr of- fZ.,o,.b 6owrvtc Puc 1,t S.jerir_ 4A4,* 2. FltL T'O bt- Ttz;TtAv Al-rk A._ I.. Onys C;t VRi02 A"Lo"'41 -, 1,7? L /% 4. Na pit is or w.4 31 3P S. No Doviovow r-;,.Ppl pt4.H wirvovr li.0 #ee AO V.4 t. L. SSmS 7v 8& Cwf.,.y lAo".0 f x- 56 1�-_? SEPTIC SYSTEM FOR DESIGNED & SUPERVISED By ...... BEDROOM HOUSE A ------ — - SOILS RATE -­ 1v e I JOHN •$. ROMEO P G. __ - - __ GAL. TANK CONSULTING ENGINEERS. TOWN OF I NORTHRIDGE ROAD L.F. F. of I-x 1 6,4 UTNI)m COUNTY PEEKSKILL, N. Y. "9.. of No ORIGINAL 'l MA 51, 118Y NEW YORK SCALE I"